基于MSCT三维影像联合logistic回归分析建立模型在肺腺癌亚型的临床预测价值及预后分析  

Establishment of a model based on MSCT three-dimensional image combined with logistic regression analysis for the clinical predictive value and prognosis of lung adenocarcinoma subtypes

作　　者：陈武 闵旭红 宋彪 王彬 李源 宋奇隆 王召华 CHEN Wu;MIN Xuhong;SONG Biao;WANG Bin;LI Yuan;SONG Qiong;WANG Zhaohua(Department of Imaging Center,Anhui Provincial Chest Hopital,Hefei 230000,China)

机构地区：[1]安徽省胸科医院影像中心,安徽合肥230000

出　　处：《医学影像学杂志》2024年第7期38-41,46,共5页Journal of Medical Imaging

基　　金：中央财政支付临床重点专科建设项目(编号:Z155080000004)。

摘　　要：目的 探讨MSCT三维影像表现联合logistic回归分析并建立模型在肺腺癌亚型的临床预测价值及预后分析。方法 选取经手术病理证实为肺浸润性腺癌且肿瘤最长径均≤3.0cm的206例患者临床资料与MSCT三维影像的定性、定量数据,根据肺腺癌亚型危险度分为MP/S+组(含有微乳头成分或实体成分组)和MP/S-组(不含有微乳头或实体成分组),两组进行比较分析,通过logistic回归分析筛选出独立预测因子并建立预测模型,然后绘制受试者工作特征(ROC)曲线对比两组IAC的效能,最后根据手术后有无邻近组织侵犯等得出其预后分析。结果 206例患者肿瘤最长径均≤3.0 cm,其中MP/S+组89例,MP/S-组117例,平均发病年龄分别为(59.0±9.5)岁、(60.6±10.3)岁,结节最长径、分叶征等在两组亚型分类之间差异无统计学意义(P>0.05);而实性成分占比>50%、毛刺征等在两组亚型分类之间差异有统计学意义(P<0.05)。Logistic回归分析结果显示实性成分占比>50%为独立预测因素,而ROC曲线显示logistic模型预测价值高于各独立预测因素。结论 通过MSCT三维影像定性、定量数据结合logistic建立模型可提高MP/S+组的诊断率,从而预测患者预后,提高生存期。Objective To investigate the clinical predictive value and prognosis analysis of MSCT 3D image feature perfor‐mance combined with logistic regression analysis and to establish a model in lung adenocarcinoma subtype.Methods The qualitative and quantitative data of clinical data and three-dimensional imaging of patients with pathologically confirmed lung in‐vasive adenocarcinoma and the longest diameter of nodules≤3.0 cm in Anhui Provincial Chest Hospital were selected for com‐parative analysis,and the risk of lung adenocarcinoma subtype was mainly divided into MP/S+group(Contains micropapillae components or solid ingredient groups)and MP/S-group(Contains no micropapillae or solid ingredient groups)for comparative analysis.The independent predictors were screened out by logistic regression analysis and the prediction model was established,and then the ROC curve was plotted to compare the efficacy of the two groups of IAC,and finally,the prognosis analysis was ob‐tained according to whether there was invasion of neighboring tissues after surgery.Results Among the 206 patients with inva‐sive adenocarcinoma,the longest diameter was≤3.0 cm,of which 89 patients were MP/S+group,117 patients were divided into MP/S-group,the average age of onset was(59.0±9.53)and(60.6±10.3)years,respectively,and there was no signifi‐cant difference between the longest diameter of nodules and lobulation signs between the two subtypes(P>0.05).The difference between the proportion of solid components>50%and burr signs in the classification of the two subtypes was statistically significant(P<0.05).The results of logistic regression analysis show that>50%of the solid components were independent predic‐tors,while the ROC curve showed that the predictive value of the logistic model was higher than that of the independent predic‐tors.Conclusion The qualitative and quantitative data of MSCT 3D images combined with logistic can improve the diagnostic rate of MP/S+group,so as to predict prognosis and to improve survival.

关 键 词：肺腺癌亚型 预后 实性成分 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.4[医药卫生—临床医学]